Breakthrough leads to the second successful eradication of HIV from a patient

Researchers in London may have cured a man of HIV in the second documented case of prolonged HIV remission. The patient - called “the London patient” for confidentiality - was diagnosed with HIV in 2003, and began retroviral therapy in 2012; shortly thereafter, he was diagnosed with Hodgkin’s lymphoma. Hodgkin’s lymphoma is often resistant to chemotherapy, necessitating a complete bone marrow transplant. The transplant procedure involves radiation therapy to destroy the patient’s cancerous immune cells, followed by the regeneration of the immune system from the bone marrow tissue of a compatible donor. The treatment is toxic, and often fails to result in complete remission; however, for many, it is the last line of defence against a ruthless disease. Once the transplant was complete and the London patient had recovered, they appeared to be HIV free.

HIV infects the immune cells of the host, entering through receptors present on the cell surface. In the early 2000’s, researchers discovered that some individuals were resistant to the disease due to the presence of a mutation in the cell surface receptor CCR5. After further investigation, it was revealed that some strains of the viral subtype HIV-1 exploit the CCR5 receptor for cell entry; the mutation resulted in the production of defective receptors, preventing the virus from entering the immune cells. Researchers hypothesized that this receptor may someday be useful for the treatment of HIV.

Fast-forward a decade, and their idea for a treatment has finally come to fruition - albeit not in the way they imagined. In an article published in 2009, a team of researchers reported that they had driven HIV into remission via a bone marrow transplant. The research team were treating a patient with both leukaemia and HIV when they proposed treating both diseases with a bone marrow transplant from a donor with the CCR5 mutation. The recipient, dubbed “the Berlin patient,” underwent complete bone marrow irradiation followed by the mutated bone marrow transplant. It appears as though the CCR5 mutant immune cells completely replaced the patient’s original cells, thereby conferring resistance to the disease. The patient has remained in both cancerous and HIV remission since treatment.

The treatment has been attempted multiple times since the original publication without success. Researchers in London recently published results indicating they had successfully eradicated both diseases in a second patient using a similar method to that which was performed on the Berlin patient. The London patient arrested antiretroviral therapy 16 months post-op and has been in confirmed HIV remission for the past 18 months.

The results of both studies have demonstrated that the elimination of HIV – once thought to be incurable – is indeed possible. The risks of treatment for otherwise healthy individuals, however, almost certainly outweighs the benefits. As mentioned, the irradiation of an HIV patient’s bone marrow is toxic. Successful destruction of all host immune cells is usually tough to achieve, and the risk of secondary infection post-irradiation is high. Additionally, finding a matching bone marrow donor is a difficult endeavour under the best of circumstances; locating a matching donor with a CCR5 mutation is exponentially more troublesome. Unfortunately, the combination of risk and donor match rarity likely relegates this treatment to the realm of experimental medicine, and nothing more. For those patients who are concurrently infected with HIV and a cancer necessitating bone marrow transplantation, this treatment may be an option; however, the availability of donors with a mutated CCR5 gene may inhibit widespread application across HIV and cancer patients. For other HIV patients, until a viable cure is discovered that involves less risk than bone marrow transplantation, antiretroviral therapy will likely remain the prescribed course of treatment. Antiretrovirals are effective, inducing nominal side effects in the majority of patients while reducing HIV in the blood to undetectable levels.

Although the London and Berlin patients are not the blinding beacon of hope that some media outlets have described, they are important actors in the conversation surrounding HIV, and medicine in a broader sense.

A cure is generally touted as the goal of most disease research. When the cure risks causing symptoms far more severe than the pharmaceutically treated disease, however, our conversation requires a recalibration. Cures are a reductionist’s dream, eliminating the need for treatment beyond initial delivery. When the cure exists on the precipice between the experimental and the extreme, however, careful consideration must be used in determining the appropriate trade-off between risk and reward.

A rundown of this years prestigious and zany research

Each year there are two organizations who dive into the wide world of academics and published research and draw from the very wide and wooly world of research, nominate a number of people and teams, and then award prizes to most deserving people or teams of people. This year is no different. The best and strangest minds have been revealed by each committee, so let’s get started with the strange.

Founded in 1991 by editor Marc Abraham of Annals of Improbable Research, this magazine is dedicated to finding the humour and satire inherent in the world of science. Before the list of Ig Nobel winners is revealed, it must be stressed that not all winners are contributing useless science, sometimes, it is the route or the way that scientists uncover their data that is the laughable aspect. Indeed, at least one Ig Nobel prize winner would later go on to win their own Nobel Prize; first for levitating a frog, second for advances in graphene research.

Medicine - Marc Mitchell and David Wartinger for research on rollercoasters and passing kidney stones.

Anthropology - Tomas Persson, Gabriela-Alina Sauciuc, and Elainie Madsen for their research on how well zoo-housed chimpanzees imitate humans (conclusion: just as well as humans who imitate chimpanzees).

Reproductive Medicine - John Barry, Bruce Blank, and Michel Boileau for their committed work on measuring nocturnal penis function through the use of postage stamps.

Economics - Lindie Hanyu Liang, Douglas Brown, Huiwen Lian, Samuel Hanig, D. Lance Ferris, and Lisa Keeping for researching the efficacy of using voodoo dolls in the workplace to retaliate against bosses (conclusion: it might help the victim, but they don’t recommend it).

Further information on the Ig Nobel Prize can be found at www.improbable.com

The Nobel Prize, in contrast, was created by inventor of dynamite, who created the explosive after witnessing the disastrous effects of unstable explosives, like nitroglycerine, which killed some of his associates. Later in life, Alfred had the experience of reading his own obituary in the newspaper, in which he was labelled a “Merchant of Death,” for his work in armaments manufacture. Since 1900 the Nobel Foundation (split between Sweden and Norway) has awarded the prizes below (except the economics prize which was created in the 1960s, although with some controversy, perhaps most notable by a living relative of Alfred Nobel, and human rights lawyer, who claimed that the Nobel Prize in Economics is a “PR coup by economists to improve their reputation”).

Physics - Arthur Ashkin, Gérard Mourou, Donna Stickland for their inventions and groundbreaking work related to the use and study of lasers. While this may seem quite staid, Ashkin’s work allowed lasers to be used to precisely move and hold molecules and even small bacteria. While Mourou and Strickland discovered the method by a which high-frequency laser could pulse in extremely short pulses without destroying the materials that make a laser work. Combining these two discoveries unlocked the massive potential of lasers, so much so that they seem quite commonplace today.

Additionally, Strickland, a Canadian, is the first woman since 1963, and the third woman ever, to receive the Nobel Prize in Physics.

Chemistry - Awarded to Frances Arnold, George Smith, and Sir Gregory Winter. Arnold directed the evolution of enzymes to become better, more efficient catalysts in certain chemical reactions and has led to more environmentally friendly methods of generating biofuels. Smith and Sir Winter directed phages to evolve in new ways to develop new antibodies against different diseases, like rheumatoid arthritis and metastatic cancer.

Medicine - James Allison and Tasuku Honjo shared this year’s prize in medicine for their discovery in the ability to inhibit “negative-immune regulation,” which is a way which cancer cells stop certain white blood cells from attacking them. by inhibiting their “immune negative” abilities they open cancer up to be attacked like regular viruses or bacteria would be. It should be noted, however, that this therapy has only efficacy over some types of cancer and side effects can be severe. Regardless, their research is widely considered groundbreaking.

Literature - This Nobel Prize will not be awarded this year following a series of scandals, not the least of which includes, financial malfeasance, infighting, confidentiality leaks, resignations, and most seriously, accusations of sexual assault. The crisis stems from one of the members of the committee, Katrina Frostenson and her husband, Jean-Claude Arnault, being accused of leaking names of the nominees to friends and relatives in order to profit from placing bets. Furthermore, Arnault has been convicted of rape after 18 different women accused him of sexual misconduct in both France and Sweden, though he has appealed the verdict.

Peace - Denis Mukwege and Nadia Murad have jointly won this year’s Nobel Peace Prize for their continued efforts to “end the use of sexual violence as a weapon of war and armed conflicts” around the world. Denis has used his position as a doctor to bring awareness to the terrible use of sexual violence in the conflicts in the Democratic Republic of Congo, condemning the DRC government as failing to do enough to put an end to the use of sexual violence in conflicts. His activism has put his family at risk and he has fled the Congo for Europe with his family.

Since 2015, Nadia Murad has spoken out about the extreme abuses and sexual violence visited upon women by soldiers of ISIS after having been captured, enslaved, tortured, and repeatedly raped herself, only escaping with the help of sympathetic neighbours who helped smuggle her out of ISIS territory. She was the first person to ever brief the United Nations Security Council on the issue of human trafficking, in which ISIS has even used social media platforms, like Facebook, as slave marketplaces that still exist. She has moved to Germany and continues to fear for her safety for her activism against human trafficking and sexual violence in conflicts.

Economics - Despite the desire by Swedish Foreign Ministers, Kjell-Olof Feldt and Gunnar Myrdal, for the prize in economics to be abolished for having been awarded to “reactionaries as Hayek (and afterwards Milton Friedman),” the prize has been awarded one again this year to William Nordhaus and Paul Romer.

Nordhaus won for his work on integrating climate change in to economic models, and who has tirelessly been trying to alert governments to the dangers of climate change to economies, and the efficacy of carbon-pricing in reducing the release of carbon emissions.

Romer was awarded the other half of this Nobel Prize for his work in researching the motivations of innovation and the effects that limit or promote innovation funding that arise from within a nation’s economy.

This upcoming March 28, from 6-9pm, Student Research Day will be taking place, displaying student research projects from different departments across the university. They currently have 93 poster projects and 9 oral presentations registered, totaling 102 participants altogether.

The day is a chance for students to proudly display their hard work to the community. Often times, students do not have much of an opportunity to share their research, and Student Research Day has become the forum for StFX students to do so. As Dr. Kolen stated, it is a chance for students to delight in their own hard work, receiving positive feedback to encourage further research projects into the future. The intent is to display students’ understanding of their work, and have professors engage with students on the students’ research, generating dialogue and interest in the otherwise unnoticed student projects.

Not only that, but it operates in order to allow time for professors and students from different departments, to come and hear about, and question, information outside of their own discipline. It is easy enough to find information concerning one’s own subject area, but harder still to do the same outside that echo chamber. Student Research Day engages the community, allowing them to branch outside of their regular field of knowledge in a way that enhances the experience of both presenters and audience alike.

This will be its 16th year in existence, as it was started in 2003 by Dr. Angie Kolen in the Human Kinetics department. Having had positive experiences sharing her own research in a similar way through her graduate studies, Dr. Kolen noticed that StFX lacked this space for students and decided to change that. She brought her idea to the university, and it was initially shot down. However, she did not take no for an answer, and the fruits of her labour are still felt today.

The research day started off as a poster fair alone, until Dr. Steven Baldner of the Philosophy Department (Dean of Arts at the time), spearheaded a movement to create oral presentations as well. The purpose of this development was to create an opportunity for those who might not have research well suited to the poster format. They would have a chance to share their own ideas and findings, but without the necessary visual representation of their work. Intended for arts students, such as English and Philosophy who might not have data fitted to a poster arrangement, the oral presentations have now become a space for all students from across all subject areas.

As it stands now, it is still Dr. Kolen and her colleagues who run the event; a hard project to maintain on top of a regular teaching workload. Dr. Kolen hopes that the university can eventually take on the project themselves to ensure its continuance and development into the future.